Transport Partnership U.S. ENVIRONMENTAL PROTECTION AGENCY Tractor Equipment Check List SmartWay Partner: Equipment Base SmartWay Tractor Company or Organization Name 0 Checklist for SmartWay Tractor 0 Quantity (Documentation for SmartWay RAM) Indicate Manufacturer, Model, Model Year Must be equipped with the following technology components: - Integrated sleeper cab w/ high roof fairing - Cab side extenders - Integrated sleeper - Cab roof fairing - Aero mirror - Aero bumper - Fuel tank faring - 2007 or later model year engine * Note: Indicate only one trailer manufacturer and model per page. Use mulitiple pages if necessary. Tractor Steer Tires (Indicate tire models and quantity) Indicate Manufacturer, Model, Model Year Tractor Drive Tires (Indicate tire models and quantity) Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Select an idling control equipment or strategy: Idling Control Equipment (Check applicable option and indicate quantity): Auxiliary Power Unit or Generator Set I I Fuel Operated Heater Battery Operated Air Conditioning and/or Heating System Thermal Storage System Idling Control Strategy (Check applicable option): Double Drivers I I Driver Overnight hotel stay Connects to Electrified Parking Space (Truck Stop Electrification) Tractor aluminum wheels (optional) Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year indicate ivianuTacturer, ivioaei, ivioaei rear Indicate Manufacturer, Model, Model Year maicate ivianuracturer, ivioaei, ivioaei rear Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year U.S. Environmental Protection Agency • EPA-420-F-14-001 • (734) 214-4052 fax • www.epa.gov/smartway ------- Transport Partnership U.S. ENVIRONMENTAL PROTECTION AGENCY SmartWay Partner: Trailer Equipment Check List Equipment "% Base SmartWay Trailer* '§. 53 foot, or longer, dry van trailer Company or Organization Name 0 Checklist for SmartWay Trailer 0 Quantity (Documentation for SmartWay RAM) Indicate Manufacturer, Model, Model Year * Note: Indicate only one trailer manufacturer and model per page. Use mulitiple pages if necessary. I Select from the following list of Required Trailer Aerodynamic Configuration Options: I Configuration A: [Trailer Tires: I I (indicate tire models and quantity) (Trailer Side Skirt: I I [Trailer front-mounted gap reducer: Configuration B: Trailer Tires: (indicate tire models and quantity) Trailer Side Skirt: Trailer Boat Tail: Optional "Total Aero" Configuration: Trailer Tires: (indicate tire models and quantity) Trailer Side Skirt: Trailer Boat Tail: Trailer front-mounted gap reducer: IConfiguation C: I Trailer Tires: (indicate tire models and quantity) I Advanced Trailer End Fairing: Configuration D: [Trailer Tires: (indicate tire models and quantity) [Advanced Trailer Skirt: Tractor aluminum wheels (optional) Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year Indicate Manufacturer, Model, Model Year U.S. Environmental Protection Agency • EPA-420-F-14-001 • (734) 214-4052 fax • www.epa.gov/smartway ------- Transport Partnership U.S. ENVIRONMENTAL PROTECTION AGENCY Equipment Check List I confirm that SmartWay Partner, has: number of tractors and/or COMPANY OR ORGANIZATION NAME number of trailers outfitted as identified above on the equipment checklist. This SmartWay Partner also commits to maintain the SmartWay Tractors and SmartWay Trailers per the manufacturer's recommendations or replace them as necessary. Permission for EPA SmartWay to publicize that we have SmartWay certified tractors/trailers within our fleet is (choose one): l_l granted CH not granted. I understand that this information may be provided to companies (mainly shippers) that inquire which SmartWay partners have certified trucks and trailers in their fleet. I further understand that SmartWay may want to publicize this information on the SmartWay website or in promotional materials. l_l By checking this box, I declare that the information submitted via this form is, to the best of my knowledge, accurate. I understand that any person who, in the course of negotiating or performing under this Agreement, makes, presents or submits a false or misleading statement to the government, or any person who makes a material omission in the course of negotiating or performing under this Agreement, may be subject to liability under all applicable civil and criminal statutes including 18U.S.C. ' 1001 (criminal liability for false statements), 31 U.S.C. ' ' 3801- 3812 (civil liability for false statements) and 31 U.S.C. ' ' 3729-33 (The False Claims Act). Print name: Title: Date: U.S. Environmental Protection Agency • EPA-420-F-14-001 • (734) 214-4052 fax • www.epa.gov/smartway ------- |